Pharmacy & Drug Cost Strategies
Expert articles and analysis related to pharmacy & drug cost strategies.
AI Summary — Last 30 Days
In the past 30 days, CMS has finalized substantial updates to 2027 Medicare Advantage and Part D payment policies, most notably the finalized Part D risk adjustment model which separates MA-PDs from standalone PDPs, fundamentally shifting plan payments for high-cost and chronic conditions and reinforcing accountability and financial sustainability across pharmacy benefits. Additionally, the CMMI-announced BALANCE model marks a significant policy experiment to expand GLP-1 access for obesity and comorbidities, signaling both increased drug spend pressure and new population health management opportunities for ACOs and plan sponsors aiming to drive outcomes in high-risk populations. These structural changes—Part D redesign and risk adjustment and BALANCE’s innovative demonstration—present both disruption and strategic repositioning opportunities for VBC-oriented organizations as the emphasis on long-term sustainability and targeted interventions intensifies.
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The FTC said the settlement will save Americans up to $7 billion in out-of-pocket costs over 10 years.
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STAT+: Asthma patients suffered as GSK pursued ‘egregious’ price hikes, senator says
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Medicare Drug Price Negotiation: What Can We Learn From the 2027 Prices and Their Justifications?
Medicare Drug Price Negotiation: What Can We Learn From the 2027 Prices and Their Justifications? Health Affairs
15 drugs selected for Medicare negotiation program
15 drugs selected for Medicare negotiation program Becker's Hospital Review
IRA Litigation: Pharma’s Failed Challenges To Medicare Drug Pricing
IRA Litigation: Pharma’s Failed Challenges To Medicare Drug Pricing Health Affairs
Poll: Public Worries About Prescription Drug Costs Reach New High; Most Across Political Parties Want Government to Do More to Regulate Prices
As the Trump administration promotes its new TrumpRx website and other efforts to lower prescription drug prices, a growing majority of the public worries about being able to afford prescription drugs...
Public Views on Prescription Drug Costs: Regulation, Affordability and TrumpRx
Amid the Trump administration's focus on lowering prescription drug costs, including its new TrumpRx website, KFF's Health Tracking Poll finds that most Americans (59%) are worried about affording pre...